Some Are More Equal Than Others

We know the old saying: be careful of what one asks for, because you might actually get it. Businessweek reports that unions were “among the biggest helpers to President Obama in getting the Affordable Care Act passed in 2010.” When they finally got what they dreamed of, it turned out they couldn’t afford it. So the unions are now asking for “tax subsidies for their members” so they can. You see, many union members “work for small employers”:

And small employers — those with fewer than 50 workers — aren’t subject to the Obamacare mandate requiring employers to either provide health coverage or pay a $2,000 penalty. The fear is that employers could decide it’s cheaper to stop offering coverage and tell workers to shop for health plans on the public marketplaces instead. The unions fear this could potentially cost their workers more money.

Unions also want to be exempted from reinsurance fees:

Labor leaders say they’re also upset about having to pay a so-called reinsurance fee the government is levying for the first three years that the public marketplaces are open. … [Unions want the same] concessions offered to big business (delaying the employer mandate until 2015) and to religious employers (allowing them to exempt contraceptive coverage from their plans). The unions are arguing that it’s now their turn for a break.

The social-engineering aspects of Obamacare mean there are different strokes for different folks — people are not equal before its mighty website. What they actually pay depends on how the bureaucracy esteems them in the scales of their social-engineering metric. If they are the wrong sort of person, the “affordable health care” will be very expensive. To get cheap health insurance, they have to portray themselves as the correct sort of person.

Take, for example, Jacqueline Proctor of San Francisco. She and her husband are in their early 60s. They have been paying $7,200 a year for a bare-bones Kaiser Permanente health plan with a $5,000 per person annual deductible. “Kaiser told us the plan does not comply with Obamacare and the substitute will cost more than twice as much,” about $15,000 per year, she says.

This new plan, Kaiser’s cheapest offering for 2014, would consume about 25 percent of their after-tax income. The new plan still has a $5,000 deductible but provides coverage for things her current policy does not, such as maternity care, healthy child visits and coverage for dependents up to age 26. Proctor has no use for such coverage, since her son is 30.

Premiums are also going up for many people next year because insurers can no longer deny coverage to people with pre-existing conditions or impose lifetime coverage caps.

The Chronicle advises people like the Proctors to work less, thereby converting themselves to the right kind of person. The Chronicle explains how it works:

To get a subsidy, the couple’s modified adjusted gross income for 2014 income would need to fall below $62,040, which is 400 percent of poverty for a family of two. (For a single person, the cutoff is $45,960. For other size households, see www.tinyurl.com/pwugnus.)

Proctor estimates that her 2014 household income will be $64,000, about $2,000 over the limit. If she and her husband could reduce their income to $62,000, they could get a tax subsidy of $1,207 per month to offset the purchase of health care on Covered California.

That would reduce the price of a Kaiser Permanente bronze-level plan, similar to the replacement policy she was quoted, to $94 per month from $1,302 per month. Instead of paying more than $15,000 per year, the couple would pay about $1,100.

They could reduce their premium to near zero by applying their subsidy to a bronze-level plan offered by the Chinese Community Health plan that costs only $1,057 per month.

In other words, the only way for the Proctor family to avoid the punitive costs imposed by affordable health care is to get poorer. The unions could do this, too — but they don’t like to get poorer.

Fortunately the unions’ political clout allows them to pursue a different strategy. They can stay rich and at the same time derive the benefits of being treated like poor people; that is, receive subsidies.

These are the “business rules” of the system. It is the difficulty of programming these convoluted rules into the Obamacare website code that has largely held it up for so long. It takes some doing to figure in all the breaks. After the unions get what they want, the programmers are going to have to shoehorn it into the code. But once they get the inequities straight, they can compile it into imperishable binary.

And the wrongness and rightness of persons will thereafter be enshrined. This is called fairness and equality.

Like most everyone else, I've been doing my best to "thread the needle" of government mayhem enacted since 2009. However, there comes a point of diminishing returns, when the best solution is: Just opt out.

Obama is clearly using the Exchanges to build a database, much as Brown in California is doing with guns (he vetoes a gun ban but leaves in place universal gun registration?). These databases have a future purpose. Opting out means staying off their lists, to the extent that's possible. Opting out means moving, no forwarding addresses, cash only transactions going forward, use of aliases everywhere possible, and seeding government lists with faulty information (i.e. your birth record becomes as reliable as Obama's). Replace credit cards with untraceable cash cards.

That may be the ultimate solution for Americans who want to rediscover their birth right of freedom. Self-sufficiency, arms, cash/gold only or barter transactions, and simply become trackless and traceless. Plus, be prepared to make a stand if the government decides to make an example of you.

I don't have any hope whatsoever that the current set of elected miscreants in DC will "solve" the current budget "crisis", debt ceiling, or "Obamacare reform". It's too little, too late, and there are too many people are in the Administration's pocket (e.g. SCOTUS Chief Justice). Congress can't "unwind" the FED money printing machine of the past five years. There's not even a PRETENSE in Washington of balancing the Federal budget. There's just no hope for economic stability and every likelihood of a free fall.

If "the world gets pneumonia when the USA gets a cold", what will happen to the world when the USA contracts HIV, Cancer, and Bubonic plague simultaneously? China wants a "de Americanized" world. They've lived off the fat of the USA for 50 years. I'll bet they rethink their position when the tsunami hits.

I have written before about the "modest proposals" I have made to my medical students in a Swiftian spirit. We can settle the whole matter of medical costs by banning everything invented or discovered after 1964. All diagnostic tests, all imaging machines, all pharmaceuticals, all prostheses, all techniques created after 1964 cost a lot more than what we had back then. If we just eliminate them we can lower the cost of medical care considerably. We would still have what was state-of-the-art only 50 years ago. At the time we all thought that was first rate.

When my students gasp at this, I point out that such items as the medical device tax and the attack against the pharma industry will create a situation in which, by 2064 we will still be practicing 2013 medicine, only a few of them get it.

Of course, when they finish absorbing that proposal I give them the one Jonathan Swift would surely understand. Kill everyone over age 80 who didn't contribute more in taxes than they consume in services. And if that doesn't work, just keep lowering the age until we reach equilibrium. They give out a double gasp on this one, but that is indirectly what we will be doing with the medical utilization boards. Algorithms will be generated that will dictate what conditions will be treated and how, according to the patient's age and other risk factors.

If, for example, your grandmother of 80 breaks her hip, she may be allowed to get a hip replacement. But if she has type 2 diabetes or if she has been treated for breast cancer successfully 25 years ago, she may be in a category of patient denied that same hip replacement.

Of course, as this thread demonstrates, special privilege will always prevail for the new aristocracy.

Torn between schadenfreude and the sense that all is going according to plan. It would serve the unions right if their members got shafted by Obamacare. But I do not think it would awaken them.

Notice that their solution is not an underlying rewriting of the plan but a special exemption based on their status. They still do not recognize that it is Obamacare itself that constitutes the problem -- or rather is the most recent manifestation of the underlying problem.

Sadly though, the failures of Obamacare are precisely part of its design. It is build for the purpose of failing so as to destroy private insurance (step one), render the new plan unworkable (step two) and generate a clamor for single payer government medicine (step three).

Watch as this unfolds and then see what follows. First they will "discover" that there is a doctor shortage. Solution? Grant Nurse Practicioners the right to become Family Practice Providers. Next, physicians will respond to requests for better service by providing Concierge Medicine for a fee. This will further stratify medical care by offering prompt appointments to those Concierge Patients and long waits for everyone else. Solution? Make Concierge Medicine illegal. Some physicians will still opt out of the government single payer system and return to fee for service. Solution? Link acceptance of the government reimbursement system to the medical license.

Next, procedure heavy specialities like Vascular Surgery, Neurosurgery, Plastic Surgery, Non-emergency orthopedic surgery, and certain time limited cancer treatments will move across the border. Patrons will establish American quality medical centers in border towns like Juarez and Tijuana and in nearby locations like post-Castro Cuba or Costa Rica. Others will seek "medical tourism" to hospitals and clinics in India, Israel, and maybe some of the Emirates. These will be staffed by American (and perhaps British or Israeli trained) physicians and nurses and will be state of the art. Chronic illnesses will still have to be treated Stateside but elective and procedure heavy matters will be treated outside of the USA.

One thing ObamaCare has done is begin to give people some idea of what health insurance really costs. Heretofore, the only people with a clue were the uninsured who tried to buy individually, the self-employed, and small business people. People with employer or union trust provided usually didn't have a clue. I've had union bargaining team members screaming at me about how unfair it was that they were expected to pay a hundred or two for health insurance and rail about evil insurance compainies and greedy doctors when the reality was the the Employer was paying $800-$1000 a month for a very nice 80-20 plan with $250 individual/$500 family deductible and a $2500 stop loss; the chump change they were paying was for AV/Dental prepayment and a supplemental play so they had 100% rather than 80-20.

I think the private/third sector union guys got rolled on ObamaCare by the public sector unions. Private/third Sector unions have what are called Taft-Hartley Trusts for benefits including health and welfare. These are theoretically joint union-employer trusts but these days it is hard to draw a line between a unionized employer and a union, so the trusts are very union friendly, one might say union dominated. The trusts manage huge amounts of money in some industries and the trusts can muscle banks and businesses with that money. Trust money also isn't covered by all the laws about use of compelled dues for political activities and such. On the other hand, few public employee unions have trusts; they are mostly straight employer provided but with negotiated rates and benefits.

Forcing the private/third sector unions into ObamaCare took away from them a major source of power and unconstained money. The public sector unions on the other hand got a step closer to taking health insurance costs out of the pie from which they can get wages and other benefits. I spent a lot of my labor relations career telling unions that if they wanted to see any money on paychecks, they had to give me relief on health insurance. Consequently, over time those deductibles went up, stop losses went up, co-pays went up, and all sorts of other cost containment features went in the plans. Twenty-five years ago the State of Alaska had far and away the highest health insurance costs in the Country, today it is mid-pack and I attribute that to the fact that beginning in the late '80s we pressed the unions on it and made sure that there was some economic signal to employees when they used their health insurance. Healthcare in Alaska is still among the most expensive in the Country, but health insurance that is reasonably designed is much less expensive than in other unionized states. On the other hand, some that aren't well designed are horrendously expensive, and the key to good design is make the employee pay something even if it is only a fraction of the actual cost.

On the "up" side, it's always nice to see big labor get b*tch slapped. If ANYTHING in our country has outlived its usefulness, its labor unions.

The news this morning is that ONLY 30,000 people nation wide have actually signed up for Obamacare. One would hope that the rest (5.6 million site visits) are engaging in civil disobedience. This is probably wishful thinking, but at this rate, the whole mess will collapse and die a well deserved death.

I wouldn't worry too much. We talked here many times about how the center is losing control. With Obama's election the attempt at these huge centrally controlled policies the subject was changed; he could drone anyone anywhere, the NSA knows where everyone is. But, Benghazi happened. The drone controllers were looking elsewhere. Boston happened, two idiots tied up a city for days. The Fed said they were going to taper, and all hell broke loose and the cost of borrowing jumped substantially in a very short time. A glitch cleared Walmart shelves as the subsidized decided to emulate the Obama Reid axis of spending.

There is no money. The idiots in control depend on the acquiescence of the population then go out of their way to destroy confidence in the mechanisms of government. A few tips on the numbers required to get a good deal on insurance will mean everyone applies for it, and it will take every penny government received to sort it all out. What are they going to do, prosecute folks for making a mistake on a poorly design piece of government trash software?

I hate to see the costs of failure, but it is the only limit to the stupidity of man. Moral strictures became the norm and expectation because folks seem to drop dead when they did what they wanted. Free enterprise is defined by the vigorous failure mechanisms that enforce discipline and winnow out fools.

We are going to see the thinking that created Detroit in all it's glory. Including the sycophantic media, the grandstanding race baiters, the vacuous twits who run departments of government into the ground.

Great post. The country will survive but the parasitic system will have to be eliminated. It will grow and grow until it becomes so obvious that no amount of friendly press, no army of thugs, no number of inspired speeches will stop the rage of the American people. This is the peak of the fever of Liberalism in the world. Many are seeing the light now: Liberalism in ALL ITS FORMS brings desolation and ruin to those nations foolish enough to adopt their suicidal tenets.

Even as a kid in grade school, I found myself wondering how it was that people were so stupid as to keep trying to take over the world when it was so obviously impossible.

This is the largest house of cards in history. The combination of arrogance and delusion has self-destruction written all over it.

The plan to transition from Ubucare to single payer, which I'm sure was the goal, depends on the ability to sell more government control as the solution. That only works if the health care gizmo is what fails, but what's happening is that the government itself is failing even to build the Trojan horse, let alone muscle it through the gates.

They will, of course, manage to ruin the best health care system in the world in the process, not to mention the country itself. But the status quo was getting boring. We were all getting fat and stupid. It's high time for a change.

The key is that the left is losing energy because they know, at least intuitively, that what I'm saying is true. They still mouth the party line, but I bet more and more of them no longer believe it. When that process really gets rolling, it/they will start to melt away like the wicked witches they are.

The worst-case scenario assumes that we go for Hillary and single-payer in 2016. Does anyone think that's going to happen? If so, why? Not just "because stupid." What solid reasons are there about America's insurance execs, doctors, patients, hospital admins, voters, disillusioned Dems and fed-up conservatives to fear Dr. Batman's predictions?

I don't know. The thing is, I think the scope of this failure -- the website disaster, the sticker shock, the insurance death spiral, an unavoidable delay of the individual mandate if not the entire law -- is going to change things.

Dr. Batman evidently thinks we're going to vote ourselves single-payer. Are we? Are a majority of Americans going to believe it when Hillary says the answer to all this is MOAR GOVERNMENT? Is there not ONE conservative who will be able to show young people and "moderates" that this would be going from the frying pan to hell's furnace?

....I think Rumsfelds Rules has something to say about the continueing screwups from the Obama administration. Donald said that "A": list folks tend to pick other "A" listers for important positions, while "B" listers are afraid of competition and pick "C" listers to do the work. Obama is , at best, a "B" lister, or perhaps a "C" lister. ...I don't think Barry knows an "A" lister from a political hack. His choice of Biden, H. Clinton and Kerry would bear that out. These people weren't picked for their management skills. Barry don't want nobody that nobody hasn't sent. Politics trumps all, even jobs that require technical ability.

The problem with “there is a lot of ruin in a nation” and “enjoy the decline” is when the full weight of that decline falls on you. I never thought the USA would collapse into the EUSSR economy in my lifetime.

The Founding Fathers started a rebellion and an eight-year was over a tax. A tax. Say, Obamacare is a tax, isn’t it?